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School Nurse questions

1. The school is saying that my kid must be evaluated by school nurse to determine that she is capable of performing the self-care tasks from the DMMP and IHP. The nurse will watch my kid perform a bg test (and anything that is checked "does independently") and evaluate if my kid is doing it correctly and I am told this is the responsibility of the nurse for legal and liability issues for care at school.

Anyone else have to do this? We are the only family, ever, in the history of the school, who has had a kid with T1 test in the classroom--so this is new to the school.

2. For older kids who do mostly self-manage. How much involvement does the nurse have in your older kid's care? Does the nurse get a report of bg's from your kid on a daily or weekly basis? How have you worked out the nurse's involvement in a kid who is doing so much more self-managing?

No, never evaluated by school - Dr checks off all the tasks that DD can perform independently and that's that.

By 6th grade, pretty much no contact with nurse other than to pick-up supplies stored there. No bgs recorded.

That is what we had in 6th and 7th grade, the new school in 8th grade wants more involvement in diabetes care, and is nervous about not knowing the bg numbers since my kid is self-testing. The school tells me that my kid's teachers are very nervous about having a kid in class, who is not seen by the nurse on a regular basis.

How do you handle lows in classroom, is there a point that your kid would alert a teacher to a low, if it was quite low? Does the nurse want to know if your child has treated a low, maybe a certain low number?

That is what we had in 6th and 7th grade, the new school in 8th grade wants more involvement in diabetes care, and is nervous about not knowing the bg numbers since my kid is self-testing. The school tells me that my kid's teachers are very nervous about having a kid in class, who is not seen by the nurse on a regular basis.

Have your endo write a letter stating that DD is self-managing, that its vital to her emotional and physical wellbeing that she be permitted to continue the effective and developmentally appropriate self-management of her chronic medical condition without interference.

IF any teachers are "nervous" ( and I doubt that) then tough luck. I do think it's important to meet with middle school teachers and in your case all the more so, but the meeting should focus on what tasks dd will be performing and how they can support her (having tabs/juice for lock down) and if needed to reassure them that dd is the best person to manage her body and it's needs and that nurses office visits are not developmentally appropriate.

Never had this. Our CDE signs off on the IHP where it says she can perform X tasks.

We are in 6th grade now, my daughter does a good chunk of the care on her own. She will call up to the nurse with her BG's when she's having a snack, the teacher knows the range of bg's for testing and will touch base with nurse as needed. She does pop in at lunch to test and on the way back to confirm bolus, but that is more a social call for her.

As for lows, my daughter tests, treats and will call the nurse. So she will call and say I'm 75, so I had a fruit leather that's 14g. Nurse will call back in 15 to see where she's at, or if she is moving about the building will swing by and check on her. As for the teacher being nervous, tough tooties. I had a meeting with my daughters core team and we outlined what she can do, what is expected of her. We stressed the importance of her staying in class and that she actually can't stand missing class because she knows it impacts her learning. The teachers were on board with this and we talked about what they can do to help.

Abby Diagnosed June '05
Pumping since Feb '06
Minimed Revel
Dexcom

Maddy Diagnosed February '15
Minimed Revel
Dexcom

Identical Twins, in nearly every way

My current position:
CIO...CHIEF INSULIN OFFICER

"Life is under no obligation to give us what we expect"...Margaret Mitchell

OMFG, this school is acting like you are asking for a KINDERGARTNER to do her own care!!!

My son is 8, and in 3rd grade, and this is the first year that he is doing some testing in the classroom. I think the teacher had the nurse come down to the room the first couple of times, just to make sure he was comfortable with what he was doing. I didn't put up a fuss about it, because he didn't care, and I think it made the teacher and the nurse feel better. But he's 8.

Originally Posted by thebestnest5

How do you handle lows in classroom, is there a point that your kid would alert a teacher to a low, if it was quite low? Does the nurse want to know if your child has treated a low, maybe a certain low number?

At this point, if my son is below 70, someone walks him to the nurse, or the teacher pokes her head out the door and watches him go. I could probably lower that to 60, but at this point, I guess I'd prefer to have him consult her if he is actually low, because (1) he's only 8 and new at this self-care thing; (2) if he has one low at school, he tends to have a low day, and I'd like the nurse to be aware of that; and (3) if his decision making is actually impaired, I want her there to help.

It's times like this when I'm actually kind of happy that we have no nurses in our district. DD is now in middle school and barring a severe low does everything herself and in class or wherever she is. Teachers or other staff will help her if she has a severe low. If she has to change her site she is to go to the office but that's more because she doesn't want to do it in class and the bathroom, well ugh. But she's on her own and at times like this I like no nurse. The endo (new for us) keeps copies of signed DMMP's with some basic to all kids filled out and then we fill out the particulars for our child. I checked what she could do on her own and nobody said a thing. I completed her 504 (well actually she has an IEP which her diabetes plan is attached to) and they just read it over and signed it. Last year at the start of middle school the only hesitation to any of it was allowing dd to have her cell phone and text me when needed. Since I had already set it up with Verizon parental controls and told them that and she couldn't contact anyone else besides family during school hours, they agreed to that pretty quickly.

Things were a little more difficult in elementary school to say the least but still nothing like that. Good luck, what a pain.

Laurie

Mom to Lia Grace, 14 yrs, dx 1/13/06 at age 5.
Started with NPH and Regular, switched to Lantus and Novolog after three months and then started pumping after 1.5 years.
CURRENTLY Pumping with the Animas Ping and using the Dexcom G4.

DD is to let the teacher know if she is so low that she thinks she needs help. They are to call the office for assistance or if she's passed out/seizing or other wise non responsive, call one of the the staff members we have trained in glucagon administration.

At the beginning of the school year last year and this, I sat down in a meeting with all of her teachers to go over her care plan and any questions they have. That seems to calm them. Thankfully dd rarely goes so low that she can't handle it herself with ease. Bad lows only seem to happen after unusual activity/foods which are rare in middle school.

Laurie

Mom to Lia Grace, 14 yrs, dx 1/13/06 at age 5.
Started with NPH and Regular, switched to Lantus and Novolog after three months and then started pumping after 1.5 years.
CURRENTLY Pumping with the Animas Ping and using the Dexcom G4.

Prior to this year, Hana was in the public school and they were very versed in Type1, having had 12 kids in the past 5 years with T1. We never had any issues. The nurses are incredible. They did as much or as little as we wanted. They were incredible when Hana was dx and we got out of the hospital. I learned so much from our nurse in 3rd grade. she kept me calm and cool those days after dx. I never feared for her safety at school, knowing she was in the best hands.
The past 2 years, we had the best school nurse ever! She is a saint. Once Hana hit 5th grade (last year), she was pretty much responsible for all her own care - other than if she was very low and she would go to the nurse's office to be watched for a bit. Or if her POD failed. The nurse knew how to change them. We are very fortunate.
This year, we took Hana out of the public school and she is in a small Christian School. She is their first with T1. But Hana is 11 and is going on three years with T1. She does all her own BS checks, blousing, treating, can change a POD. But because the nurses do not know anything, they are really on edge and nervous wrecks and making things much harder than they need to be. Beside the nurse approaching me on Monday saying that Hana needs to come to her office for all blood sugar checks because she will contaminate everyone - that didn't go over well and I gave her an education on the law and contamination via test strip right there in the parking lot where she decided would be an appropriate place to confront me (My husband who witness it, said the 2 nurses looked like deer in headlights as I educated them), she also said that Hana needs to report all her numbers to them because they need to know. I told them it wasn't necessary. Hana knows what needs to be done or not done. She doesn't need to report her numbers. The teachers have been alerted to the symptom of serious lows and Hana knows to ask for them to call the nurse if she is very low. But other than that, reporting anything is completely unnecessary, disruptive and a waste of everyone's time. She's 11 and responsible. We aren't talking about a 1st grader here. Even in 3rd grade when she was first dx, she was doing all her own BS checks in the classroom. They only called the nurse when she was low or high.
I hope to get this all straightened out this week. I miss our old nurses!